Hewitt Maria E, Bamundo Annette, Day Rebecca, Harvey Catherine
Institute of Medicine, The National Academies, Washington, DC, USA.
J Clin Oncol. 2007 Jun 1;25(16):2270-3. doi: 10.1200/JCO.2006.10.0826.
Cancer survivors have many medical and psychosocial needs that are unaddressed in the post-treatment period. Qualitative research was carried out to assess how a survivorship care plan created by oncologists could improve the quality of survivorship care.
Focus groups and interviews conducted with cancer survivors, nurses, primary care physicians, and oncologists provide insights into post-treatment follow-up practices and the acceptability and feasibility of providing survivors and referring physicians with a cancer survivorship care plan.
Cancer survivors reported satisfaction with post-treatment medical care, but felt that their psychosocial needs were not met. Survivors expressed enthusiastic support for receipt of a follow-up care plan. Primary care physicians viewed themselves as playing an important role during the post-treatment period and indicated that a written care plan for follow-up would help them improve their survivorship practices. Nurses recognized the need to improve the care of cancer survivors and suggested that they could play an active role in creating and implementing cancer survivorship plans. Physicians providing oncology care acknowledged the value of survivorship care plans, but were not inclined to complete them because such plans would not reduce other reporting and communication requirements and would be burdensome to complete given their busy schedules.
Survivorship care planning is viewed favorably by consumers, nurses, and physicians, however there are several barriers to its adoption. Barriers may be overcome with: electronic medical records, changes in reporting requirements of insurers, advocacy on the part of patients, and incorporation of care planning in education and training programs.
癌症幸存者在治疗后的一段时间内有许多未得到满足的医疗和心理社会需求。开展了定性研究，以评估肿瘤学家制定的生存护理计划如何能够改善生存护理的质量。
对癌症幸存者、护士、初级保健医生和肿瘤学家进行焦点小组讨论和访谈，以深入了解治疗后的随访实践，以及为幸存者和转诊医生提供癌症生存护理计划的可接受性和可行性。
癌症幸存者对治疗后的医疗护理表示满意，但觉得他们的心理社会需求未得到满足。幸存者对收到后续护理计划表示热烈支持。初级保健医生认为自己在治疗后阶段发挥着重要作用，并表示书面的后续护理计划将有助于他们改善对幸存者的护理实践。护士认识到需要改善对癌症幸存者的护理，并建议他们可以在制定和实施癌症生存计划中发挥积极作用。提供肿瘤护理的医生认可生存护理计划的价值，但不倾向于完成这些计划，因为此类计划不会减少其他报告和沟通要求，而且鉴于他们日程繁忙，完成起来会很繁琐。
消费者、护士和医生对生存护理计划的评价较高，然而在采用该计划方面存在若干障碍。这些障碍可通过以下方式克服：电子病历、保险公司报告要求的改变、患者的倡导以及将护理计划纳入教育和培训项目。
